Revision lecture/other Flashcards
10 steps of an outbreak investigation
Prepare for field work
Establish the existence of an outbreak
Verify the diagnosis
Construct a working case definition
Find cases systematically and record information
Perform descriptive epidemiology
Develop hypotheses
Evaluate hypotheses epidemiologically
As necessary, reconsider, refine, and re-evaluate hypotheses
Compare and reconcile with laboratory and/or environmental studies
Implement control and prevention measures
Initiate or maintain surveillance
Communicate findings
what do you talk about in an epidemiological question
time and place (high risk setting, seasonality), high risk groups (transmission, susceptibility), cause, different types, broad incubation period, determinants
ways to prevent spreading of disease
mass screening
no mass gatherings
exclusion from schools
no swimming
reasons for peaks in epidemiological graphs
seasonal outbreak random - spurious increase reporting bias new technology other new programmes leading to that compare to hospital data - more admitted
advantages and disadvantages of passive surveillance and when would you use
ads: already in place, covers large area, see trends, cheap, good for common disease
discs: incomplete info, different in reporting patterns, may not be reliable
notifiable diseases, seasonal flu, common things
advantages and disadvantages of active surveillance and when would you use
ads: more complete, better quality data, more data, find rare diseases, good in outbreaks, can set up which data you want
discs: time consuming, heave to set up, expensive,
outbreak suspicion
what is sentinel surveillance
specific diseases recorded in a few areas - could miss out data
what do you need to know when implementing a programme?
why would you implement it?
what are problems?
what are considerations?
who are high risk groups/areas?
do you want selective or universal immunisation?
whats prevalence of disease? whats burden?
social and cultural factors
logistics - cold chain, staffing, who delivers
cost-effectiveness
monitoring and evaluation
sustainability
prevention of respiratory diseases
resp hygiene vaccines PPE isolation - ventilation cleaning/hygiene education - early detection and respiratory hygiene treatment screening continued surveillance immunisation
difference between active and passive immunisation in terms of speed of onset, duration of protection and component
active: slow to fast, long (years) and vaccine
passive: immediate, short (weeks), antibodies
how to prevent and control gi diseases
solid waste management hand hygiene opportunities isolation gloves, gowns, masks detecting source of infection bare below elbows product recall keep environment clean vaccinations chlorination of water prevent open defecation shut down food premise no swimming treat patients vaccination - hep A?
groups at risk of spreading GI infections
food handlers, children, homeless, elderly, disabilities, health and social care workers, babies, immunocompromised,
how to prevent malaria
insecticide - nets and home repellant personal protection nettings on door and windows treat infected people chemoprophylaxis community education
how to prevent and control HIV
condom sharps management treat screening pre exposure prophylaxis post exposure prophylaxis c section education for high risk groups treatment for other STIs reduce stigma screen for TB and treat needle exchange programmes screening blood products abstinence
high risk groups for STIs
drug use
multiple partners
unprotected sex
sex workers
why are healthcare associated infections increasing
more invasive procedures more elderly/high risk groups more antibiotic issue increase pressure on staff - bad habits crowding increased hospital stay interactions with multiple staff workers visitor regulations relaxed poor equipment management - single use equipment, cleaning of equipment poor waste disposal stagnant air/unclean air increased immunosuppressive treatments hospital water systems food poisoning people with infectious disease coming to hospitals increase AMR
why increase in AMR
increased use of antibiotics inappropriate use of antibiotics bacterial evolution sub therapeutic levels prescribed giving antibiotics when not needed medical tourism time
how to prevent hospital acquired infections
reduce invasive procedures catheter removal dates sterile procedures discharge patients when medically fit have antibiotic policy - when to use, how long for, when to stop swab regularly for MRSA train staff reduce visitors reduce movement of staff and patients care for patients outside hospital setting education surveillance infection control audits/training isolation rooms - same infection in one room single rooms barrier methods - gloves, mask, hand washing
purpose of vaccinations
protect high risk groups
eradicate infectious agent
contain an infection in a population
framework for decision making
disease burden - is it a public health problem
is immunisation best strategy to control this
net impact of introducing a new vaccine
how well is current immunisation programme working
how much disease will be prevented
what are negative effects
what resources will be needed
Who? how? when?
